Objective
To examine mental health conditions among hospitalized individuals with Parkinson disease in the United States.
Methods
Serial cross sectional study of hospitalizations of individuals ages ≥60 identified in the Nationwide Inpatient Sample dataset from 2000–2010. We identified all hospitalizations with a diagnosis of PD, alcohol abuse, anxiety, bipolar disorder, depression, impulse control disorders, mania, psychosis, substance abuse and attempted suicide/suicidal ideation. National estimates of each mental health condition were compared between hospitalized individuals with and without PD. Hierarchical logistic regression models determined which inpatient mental health diagnoses were associated with PD, adjusting for demographic, payer, geographic and hospital characteristics.
Results
We identified 3,918,703 mental health and substance abuse hospitalizations. Of these, 2.8% (n=104, 437) involved a person also diagnosed with PD. The majority of MHSA patients were white (86.9% of PD versus 83.3% of non-PD). Women were more common than men in both groups: (male: female prevalence ratio- PD: 0.78, 0.78–0.79, non-PD: 0.58, 0.57–0.58).
Depression (AOR 1.32, 1.31–1.34), psychosis (AOR: 1.25, 1.15–1.33), bipolar disorder (AOR 2.74, 2.69–2.79), impulse control disorders (AOR: 1.51, 1.31–1.75), and mania (AOR 1.43, 1.18–1.74) were more likely among PD patients, alcohol abuse was less likely (AOR: 0.26, 0.25–0.27). We found no PD-associated difference in suicide related care.
Conclusions
Parkinson disease patients have unique patterns of acute care for mental health and substance abuse. Research is needed to guide PD treatment in individuals with pre-existing psychiatric illnesses, determine cross provider reliability of psychiatric diagnoses in PD patients, and inform efforts to improve psychiatric outcomes.